US Nurses Fight to Unionize


Nurses in the US are increasingly organizing to form unions in response to the negative impact which the for-profit health care system in the US is having on patient care. At the same time, there appears to be mounting push-back by hospital administrators against unionization.

Nurses and labor unions

Legislation providing for the right for workers in the US to unionize was first introduced in 1935.  During the past 30 years union membership has however dwindled to a national average of around 13% of all employees. To gain labor union representation in the US, employees must either get voluntary recognition by the employer, or the majority have to vote for union representation.

Nurses resisted unionization for many decades as it was considered to conflict with professional values. This has changed over time as the need for collective bargaining to improve nurses’ conditions of service became increasingly evident.

Today around 21% of nurses in the US belong to a collective bargaining unit.  Going by news reports it appears as though there is a growing push among hospital-employed nurses to unionize – and for management to come out in strong opposition to this move.

Growing unionization among nurses 

The Guardian reported that nurses at the Beaumont Hospital in Michigan began organizing earlier this year to form a union with the Michigan Nurses Association for the 3,200 nurses working at the hospital.

“We take a vow to provide the best care we can and that has a lot to do with why there are so many nurses trying to organize,” said Liz Martinez, a nurse at Beaumont Hospital involved in the union organizing drive.

Management hired union-busting consultants, forced nurses to attend hour-long information sessions, and even changed a nurse’s job to prevent her from speaking to others.


At Johns Hopkins Medical Centre in Maryland, which employes 3,200 nurses, a union push was started last year to address understaffing, high turnover, low pay, and a high level of violence against nurses.

Here also, the nurses experienced strong opposition from management. They retained a union-busting firm, nurses were prevented from talking at work about unionizing, anti-union information was distributed, and security was called in when nurses discussed union activity in break rooms.

Eventually, a settlement was reached after unfair labor practice charges were laid with the National Labor Relations Board (NLRB). Management was required to post signs that nurses had the right to unionize and were not to interfere when nurses exercised this right.

Similar opposition, including hiring a union-busting firm, has been experienced by nurses at St. Mary Medical Centre in Pennsylvania who are currently preparing to vote on unionization.

This year, unionization drives by groups of nurses have been successful in winning union elections at a number of hospitals. This includes the St Alexius hospital in North Dakota and Kalispell Medical Centre in Montana. At Unity Center for Behavioral Health in Portland, although the vote to unionize was won with 86%, management has lodged an appeal with the NLRB.

Push back against unionization 

Resistance against unionization in the US appears to be widespread. Recent changes have been made to legislation which significantly reduced the permitted activity of unions representing federal employees.

“We’ve never seen anything like it,” said David Cann, of the American Federation of Government Employees. “We’ve seen a level of hostility toward labor unions that is unique and more coordinated from what we’ve seen from other administrations.”


Frieda Paton is a registered nurse with a Master’s degree in nursing education. Her passion for nursing education, nursing issues and advocacy for the profession were ignited while she worked as an education officer, and later editor, at a national nurses’ association. This passion, together with interest in health and wellness education since her student days, stayed with her throughout her further career as a nurse educator and occupational health nurse. Having reached retirement age, she continues to contribute to the profession as a full-time freelance writer. In the news and feature articles she writes for Nurseslabs, she hopes to inspire nursing students and nurses on the job to reflect on the trends and issues that affect their profession and communities - and play their part in advocacy wherever they find themselves.

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